Maine reproductive healthcare providers were scrambling Monday morning after the U.S. Supreme Court restored access by mail to mifepristone, a widely used abortion medication.

A lower-court had ruled Friday that mifepristone could only be obtained in person from healthcare providers. Telehealth, an increasingly common way to receive medication abortions, was blocked in Maine and across the nation.

Staff members at Planned Parenthood of Northern New England spent the weekend meeting after hours, rereading court decisions and figuring out what to tell patients before Monday rolled around. Then, midmorning Monday, an order by Justice Samuel A. Alito Jr. paused the lower-court ruling and temporarily restored nationwide access by mail until May 11.

Nicole Clegg, president and CEO of Planned Parenthood of Northern New England, which provides abortion services to hundreds of Mainers at health centers and via telehealth, said the rulings have caused undue confusion for both providers and patients.

“To be a healthcare provider and to have information radically changed after hours on a Friday night, that you then have to respond to by Monday morning to make sure that the patients that are coming to you — counting on you — can continue to count on you: That is just gross and unjust,” Clegg said.

“Why should people have to go through this kind of uncertainty?”

Access to mifepristone will be decided by the same Supreme Court that in 2022 struck down Roe v. Wade, eliminating the nationwide right to abortion. Abortion providers worry that permanently restricted telehealth access could make it more difficult to receive medication abortions in Maine, especially for people who live in rural areas, lack transportation or can’t leave full-time jobs for appointments.

They also want to reassure patients that medication abortion is still legal in Maine.

“Until May 11th, folks can still access mifepristone and misoprostol via telehealth,” said Olivia Pennington, director of advocacy and community engagement at Maine Family Planning, a statewide sexual and reproductive healthcare provider. “And beyond that, telehealth abortion care will remain legal in the state of Maine.”

Medication is the most common method for abortion in the United States. Planned Parenthood of Northern New England, which sees patients in Maine at four health centers and by telehealth, provided 1,259 abortions in the state in fiscal year 2025. Medication abortions made up 66% of the procedures.

Medication abortions are typically delivered as a two-drug regimen that includes mifepristone to end the pregnancy and misoprostol 24-48 hours later to cause the uterus to expel the pregnancy tissue. The two drugs are most effective together, Clegg said, reducing side effects, pain and the likelihood of needing follow-up care.

The state of Louisiana sued the Food and Drug Administration to restrict access to mifepristone, saying that medication by mail has allowed abortions to continue despite a near-total ban in the state. Friday’s ruling from the 5th U.S. Circuit Court of Appeals reinstated an FDA requirement that people visit medical providers in person to obtain mifepristone.

Before Monday, Clegg said the organization had planned to change to a misoprostol-only medication abortion drug protocol for telehealth appointments. Leaders at Maine Family Planning and Mabel Wadsworth Center, a sexual and reproductive healthcare provider in Bangor, were considering the same.

While misoprostol-only is a safe and effective abortion protocol, Aspen Ruhlin, community engagement manager at Mabel Wadsworth, said, “it is a crampier, more physically uncomfortable experience.”

“It can take a little bit longer,” Clegg said. “It can require more dosing.”

Planned Parenthood of Northern New England reverted to its two-drug regimen when the Supreme Court paused the ruling.

“We quickly pivoted back to business as usual,” Clegg said. “So we’re able to meet the needs of our patients who are counting on us for today. But this is incredibly disruptive.”

Clegg said causing confusion is a strategy for abortion opponents, who have targeted telehealth and prescription by mail to keep people from accessing abortion in states where abortion is banned. There are total abortion bans in 13 states. Abortion is legal in Maine.

In the first half of 2025, 27% of all abortions in the United States were provided via telehealth, according to a report from the Society of Family Planning, which specializes in abortion science.

Patients across Maine utilize telehealth services, including at Maine Family Planning, which has 18 clinics across many rural parts of the state. Pennington said telehealth makes it possible for people to access care regardless of where they live or how much they make.

“We know that Maine doesn’t have public transportation, and that there are barriers to care like access to transportation, time off of work, getting childcare, lost wages,” Pennington said. “So telehealth is a vital tool to ensure that rural Mainers can access the full suite of sexual and reproductive healthcare.”

Mabel Wadsworth provided 265 abortions in 2025. While most patients come from the Bangor area, Ruhlin said even local patients rely on some virtual options for medication abortions: “talking with a provider over telehealth but then actually swinging by the office to pick up the medications.”

It can be faster than waiting for medication in the mail.

Others prefer the virtual meetings to walking into reproductive health clinics, which remain a target for anti-abortion protests. Clegg said patients may have to walk through protesters who stand at some Planned Parenthood of Northern New England health centers, but that once they come in, “what they find is a welcoming, safe space.”

She said that will not change, even amid attempts to curtail access to abortion from outside of Maine.

The Supreme Court’s order will remain in effect for another week while both sides in the Louisiana case respond and the high court considers the issue more fully.